What Factors are Associated with Health-Related Quality of Life in Mixed Dentition Children?

Abstract Objective: To associate the OHRQoL and HRQoL in mixed dentition children with the influence on age range, socioeconomic and clinical variables. Material and Methods: A cross-sectional study was carried out with 1,240 children between 6 and 12 years of age. HRQoL was assessed by the Quality of Life Assessment Scale, considered an outcome variable. OHRQoL was determined using specific questionnaires related to the age group: Oral Health Impact Scale in Early Childhood, Child Perceptions Questionnaire for 8 to 10 years, and 11 to 12 years. Dental caries and malocclusion were diagnosed. The socioeconomic class was evaluated. A multiple negative binomial regression analysis was used to test the relationship between HRQoL, OHRQoL scores and socioeconomic and clinical variables. Correlation analyses were performed between the total HRQoL and OHRQoL, with a significance level of 5%. Results: The HRQoL is inversely related to the impact of OHRQoL (p<0.05), modulated by the age group. There was a significant weak negative correlation between the HRQoL scores and the impact of OHRQoL (p<0.05). Conclusion: The OHRQoL impacts the HRQoL, modulated by the age group and with minor influence from socioeconomic and clinical variables (AU).

A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents

Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact (AU).

Knowledge and clinical practices of orthodontists regarding the treatment of patients with aids. A nationwide study

Aim: To evaluate orthodontists' knowledge and clinical practices regarding the treatment of patients with HIV/AIDS. Methods: Cross-sectional study performed with 655 Brazilian orthodontists based on a previously calculated sample size. Self-administered questionnaires were sent to orthodontists to collect information on knowledge and clinical conduct regarding the care of patients with HIV/AIDS. The study evaluated the awareness of possible risk factors for contamination, oral manifestations of HIV, need for more information on the care of HIV-positive patients, whether orthodontic treatment is indicated in HIV-positive patients, and whether they had knowingly performed orthodontic treatment in HIV-positive patients. Simple regression models were adjusted, and crude Odds Ratios estimated the associations with 95% confidence intervals. The variables with P < 0.20 in the crude analysis were tested in multiple logistic regression models, and those with P ≤ 0.05 were maintained in the final model. Magnitudes were estimated by adjusted Odds Ratios values, with 95% confidence intervals. Results: Orthodontists who were aware of the oral manifestations of HIV/AIDS, those having work experience of more than 20 years, and those who believed that orthodontic treatment could be indicated for these patients were 3.30 (1.79-6.10), 2.74 (1.36-5.52) and 1.92 (1.13-3.24) times more likely to perform orthodontic treatment in HIV-positive patients, respectively. Most orthodontists (92.9%) reported they needed to obtain more information about orthodontic care in patients with HIV/AIDS. Conclusion: Although orthodontists reported feeling able and qualified to provide dental care to patients with HIV/AIDS, gaps in their knowledge need to be addressed with further training

Impact of malocclusion severity on the quality of life of non-white adolescents / Impacto da severidade da má oclusão na qualidade de vida de adolescentes não brancos

Abstract The aim of this study was to evaluate the impact of malocclusion severity on the oral health-related quality of life (OHRQoL) of non-white adolescents. A cross-sectional study was conducted with 585 non-white Brazilian adolescents (12-15 years). The Dental Aesthetic Index (DAI) was used for the clinical assessment of malocclusion and Oral Health Impact Profile (OHIP-14) on OHRQoL. Deep bite and transverse occlusal relationships were assessed in association with the DAI. The adolescents with DAI 3 and 4 were distributed into 4 groups: G1 - individuals without transverse occlusal relationships or deep bite; G2 - individuals with only posterior crossbite; G3 - individuals with only deep bite; and G4 - individuals with Brodie bite. The backward stepwise procedure was used to select variables on each level, eliminating variables with a p≤0.20. From the logistic regression analyses, the adjusted odds ratios were estimated with the respective 95% confidence intervals. The adolescents with severe malocclusion divided into the G2, G3 and G4 showed p-value of 0.0501, 0.1475, and 0.5407, respectively, but did not remain in the final model. Malocclusion severity had no impact on the OHRQoL of non-white adolescents.

Resumo O objetivo deste estudo foi avaliar o impacto da severidade da má oclusão na qualidade de vida relacionada à saúde bucal (OHRQoL) de adolescentes não brancos. Estudo transversal foi realizado com 585 adolescentes brasileiros não brancos (12-15 anos). O Índice de Estética Dental (DAI) foi utilizado para a avaliação clínica da má oclusão e o Oral Health Impact Profile (OHIP-14) na OHRQoL. A sobremordida profunda e as relações oclusais transversais foram avaliadas em associação com o DAI. Os adolescentes com DAI 3 e 4 foram divididos em 4 grupos: G1 - indivíduos com relação transversal normal ou com ausência de sobremordida; G2 - indivíduos com mordida cruzada posterior; G3 - indivíduos com sobremordida profunda; e, G4 - indivíduos com mordida em Brodie. O modelo final estimou as variáveis selecionadas após o ajuste para aquelas que permaneceram no modelo multivariado em níveis iguais e superiores. A partir das análises de regressão logística, os odds ratios foram ajustados e estimados com os respectivos intervalos de confiança de 95%. Os adolescentes com má oclusão severa divididos em G2, G3 e G4 mostraram um p-valor de 0.0501, 0.1475, e 0.5407, respectivamente, mas não permaneceram no modelo final. A severidade da má oclusão não teve impacto na OHRQoL de adolescentes não brancos.

The influence of elastomeric ligatures pigmentation on smile aesthetics during orthodontic treatment

ABSTRACT Aim: To assess the influence of elastomeric ligatures, subjected to a previous in vitro pigmentation process using different substances, on smile aesthetics during orthodontic treatment, from the perception of students and professionals. Methods: Eight elastomeric ligatures of five commercial brands (3M/Unitek, American Orthodontics, Morelli, Ortho Technology, and Orthometric) (n=8) were immersed in coffee, Coca-Cola, and red wine for one minute per day, for 28 days; and another group of ligatures was immersed in artificial saliva. All samples were photographed and subsequently analyzed using the Adobe Photoshop software, by the RGB method. Afterwards, the pigmented ligatures were inserted in a patient wearing orthodontic brackets, and zoomed photographs of the smile were taken and presented to 40 evaluators, who filled in a satisfaction scale sheet to express their opinion on the smile aesthetics of each photograph. The color data were subjected to analysis of variance (ANOVA) and Tukey tests. Results: The substance with the highest pigmentation potential was coffee (p< 0.05) followed by red wine (p< 0.05). Comparison among the brands used in this study showed that American Orthodontics and Orthometric had the lowest degree of pigmentation when immersed in coffee and red wine (p< 0.05), respectively. However, the brand that showed the highest level of satisfaction among the evaluators was Ortho Technology. Conclusions: The presence of pigmented elastomeric ligatures affected smile aesthetics, when compared with the control group.

RESUMO Objetivo: Avaliar a influência das ligaduras elásticas submetidas a um processo prévio de pigmentação in vitro, com diferentes substâncias, na estética do sorriso durante o tratamento ortodôntico, segundo a percepção de alunos e profissionais. Métodos: Oito ligaduras elásticas de cinco marcas comerciais (3M Unitek, American Orthodontics, Morelli, Ortho Technology e Orthometric) (n = 8) foram imersas em café, Coca-Cola e vinho tinto por um minuto por dia, por 28 dias, e outro grupo de ligaduras foi imerso em saliva artificial. Todas as amostras foram fotografadas e posteriormente analisadas no software Adobe Photoshop, pelo método RGB. Em seguida, as ligaduras pigmentadas foram inseridas em um paciente com braquetes ortodônticos, e fotografias ampliadas do sorriso foram tiradas e apresentadas a 40 avaliadores, que preencheram uma escala de satisfação para representar sua opinião sobre a estética do sorriso de cada fotografia. Os dados de cor foram submetidos à análise de variância (ANOVA) e testes de Tukey. Resultados: A substância com maior potencial de pigmentação foi o café (p< 0,05), seguido do vinho tinto (p< 0,05). A comparação entre as marcas utilizadas nesse estudo mostrou que a American Orthodontics e a Orthometric apresentaram o menor grau de pigmentação quando imersas em café e vinho tinto (p< 0,05), respectivamente. Porém, a marca que apresentou maior nível de satisfação entre os avaliadores foi a Ortho Technology. Conclusões: A presença de ligaduras elásticas pigmentadas afetou a estética do sorriso, quando comparada à do grupo controle.

Micrographic evaluation of different widia compositions of orthodontic pliers submitted to peracetic acid and intensive use / Avaliação micrográfica de diferentes composições de widia de alicates ortodônticos submetido ao ácido peracético e uso intensivo

Introduction: The sterilization and disinfection procedures should be adapted to the chemical profile of the metal alloys present in the instruments. Objective: This study aimed to perform a micrographic assessment on the surface characteristics of the widia of orthodontic pliers with two alloy compositions subjected to the action of 0.2% peracetic acid and intensive use. Material and method: Twenty distal cutting pliers were divided into two groups (n=10) according to widia composition (%wt): W1- 85% to 87% of tungsten carbide (TC) and other components in the proportion of 13% to 15% and W2 - 87.5% to 88.5% of tungsten carbide and 11.5% to 12.5% for other components. All the pliers were assessed in a stereoscopic magnifying glass (32x) after three treatments: before use (T0); after cutting 100 segments of rectangular stainless-steel wires - intensive use (T1); and after 100 sterilization cycles in 0.2% peracetic acid and intensive use (T2). The cutting sites of all pliers were standardized. Widia regions were defined by line "A" representing T1 and line "B" representing T2. A frequency distribution table and Fisher's exact test (α=0.05) was performed. We assessed two widia from each composition and treatment in SEM and energy-dispersive X-ray spectroscopy (EDS/SEM). Result: The results showed that W1 pliers presented significantly fewer defects after the sterilization cycles with peracetic acid and intensive use than W2 pliers (p=0.0198). There were no differences between both pliers after intensive use (p=1.000). Conclusion: The SEM images and EDS analyses showed changes in widia surfaces after the different treatments. Widia composition affected the resistance of the orthodontic pliers after sterilization cycles with 0.2% peracetic acid and intensive use.

Introdução: Os procedimentos de esterilização e desinfecção devem ser adaptados ao perfil químico das ligas metálicas presentes nos instrumentos. Objetivo: O objetivo do estudo foi realizar uma avaliação micrográfica das características da superfície da widia de alicates ortodônticos com duas composições de ligas submetidas à ação de ácido peracético a 0,2% e uso intensivo. Material e método: Vinte alicates de corte distal foram divididos em dois grupos (n=10), de acordo com a composição widia (% em peso): W1- 85% a 87% de carboneto de tungstênio e outros componentes na proporção de 13% a 15% e W2 - 87,5% a 88,5% de carboneto de tungstênio e 11,5% a 12,5% para outros componentes. Os alicates foram avaliados em uma lupa estereoscópica (32x) após três tratamentos: antes do uso (T0); após corte de 100 segmentos de fios retangulares de aço inoxidável- uso intensivo (T1); após 100 ciclos de esterilização em ácido peracético a 0,2% e uso intensivo (T2). Os locais de corte dos alicates foram definidos pela linha "A" representando T1 e pela linha "B" representando T2. Foi realizada uma tabela de distribuição de frequências e o teste exato de Fisher (α=0,05). As widias foram avaliadas em MEV e Espectroscopia de Energia Dispersiva. Resultado: Os alicates W1 apresentaram defeitos significativamente menores após os ciclos de esterilização com ácido peracético e uso intensivo do que os alicates W2 (p=0,0198). Não houve diferenças entre os dois alicates após uso intensivo (p=1.000). Conclusão: As imagens de MEV/EDS mostraram alterações nas superfícies widia após os diferentes tratamentos. A composição widia afetou a resistência do alicate ortodôntico após ciclos de esterilização com ácido peracético a 0,2% e uso intensivo.

Effect of hydrofluoric acid concentration and thermal cycling on the bond strength of brackets to ceramic

Abstract This study to evaluate the effects of different hydrofluoric acid (HF) concentrations and thermal cycling on the shear bond strength (SBS) of brackets to ceramic. Cylinders of ceramic were divided into 10 groups (n=15), according to HF concentrations: 1-1%;2-2.5%;3-5%;4-7.5%;5-10% (storage 24 h); 6-1%;7-2.5%;8-5%;9-7.5%; and, 10-10% (thermal cycling). All cylinders were etched for 60s and received one layer of silane. Metallic brackets were bonded to the cylinders using Transbond-XT, light activated for 40 s, using a LED (Radii Plus) and stored in deionized water at 37o C for 24h. The groups 6 to 10 were submitted to thermal cycling (7,000 cycles - 5o/55oC). SBS was performed in an Instron at crosshead speed of 1.0 mm/min. Data were submitted to two-way ANOVA and Tukey's post-hoc test (α=0.05). The Adhesive Remaining Index (ARI) was evaluated at 40x magnification. The different HF acid concentrations influenced on the SBS of the brackets to ceramic (p<0.05). The thermal cycling decreased the SBS of the brackets to ceramic for all acid concentrations (p<0.05). The ARI showed a predominance of scores 0 for all groups, with an increase in scores 1, 2 and 3 for the group storage for 24 h. In conclusion, the different HF acid concentrations 5.0%, 7.5% and 10% influenced on the SBS of brackets to ceramic. The thermal cycling decreased significantly the SBS of brackets to ceramic.

Resumo Este estudo avaliou os efeitos de diferentes concentrações de ácido hidrofluorídrico (HF) e ciclagem térmica na resistência de união ao cisalhamento (RUC) de bráquetes metálicos a cerâmica. Cilindros da cerâmica feldspática foram divididos em 10 grupos (n=15). De acordo com as concentrações do ácido HF: 1-1%;2-2,5%;3-5%;4-7,5%; e, 5-10% (armazenagem por 24 h); 6-1%;7-2,5%;8-5%;9-7,5%; e, 10-10% (ciclagem térmica). Todos os cilíndros foram condicionados por 60s e receberam uma camada de silano. Bráquetes metálicos foram colados aos cilíndros usando o transbond-XT, fotoativado por 40 s, usando o LED (Radii Plus; SDI) e armazenados em água deionizada a 37o C por 24 h. Os Grupos 6 a 10 foram submetidos à ciclagem térmica (7.000 ciclos - 5o/55oC). RUC foram realizadas na Instron a velocidade de 1.0 mm/min. Os dados foram submetidos à análise de variância dois-fatores e ao teste de Tukey's post-hoc (α=0,05). O Índice de Remanescente do Adesivo (IRA) foi avaliado com 40x de aumento. As diferente concentrações do ácido HF influenciou na RUC dos bráquetes na cerâmica (p<0,05). A ciclagem térmica diminuiu a RUC dos bráquetes na cerâmica para todas as concentrações do ácido (p<0,05). O IRA mostrou predominância de escores 0 para todos os grupos, com aumento de escores 1, 2 e 3 para os grupos armazenados por 24 h. Concluíndo, as concentrações do ácido HF 5,0%, 7,5% e 10% influenciaram na RUC de braquetes à cerâmica. A ciclagem térmica diminuiu significativamente a RUC do bráquetes à cerâmica.

A comparative analysis of the frictional resistance of esthetic orthodontic wires / Avaliação do atrito de fios ortodônticos estéticos

Abstract Introduction The orthodontic movement is directly influenced by the ability of orthodontic wires to slide through brackets and tubes. Therefore, the main concern during orthodontic movement corresponds to the frictional forces generated at the bracket-orthodontic wire interface. Objective This study aimed to evaluate the frictional resistance of esthetic orthodontic wires. Material and method Fifty test brackets were obtained and divided into five groups (n = 10) based on the type of rectangular orthodontic wire, as follows: conventional metallic wire (Morelli, Brazil) (G1, control group) and esthetic wires (G2, Ortho Organizer; G3, Tecnident; G4, Trianeiro; and G5, TP Orthodontics). The following materials and conditions were used: 0.019 x 0.025-inch wires, ceramic brackets with edgewise prescription, torque and/or angulation of 0°, and 0.022 x 0.028-inch slots. The specimens were tested for their tensile strength using an Instron universal test machine at a speed of 1.0 mm / min and a load cell of 500N. The tensile strength data were analyzed by one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test, with a 5% significance level. Result The frictional resistance (N) of the metallic orthodontic wire (8.07 ± 0.43) was significantly higher than that of the esthetic wires: Ortho Organizer (4.01 ± 0.25), Tecnident (3.87 ± 0.31), Trianeiro (4.47 ± 0.26) and TP Orthodontics (4.49 ± 0.30) (p <0.05), with no significant difference between them (p> 0.05). Conclusion To conclude, the esthetic orthodontic wires tested herein showed less frictional resistance as compared to the conventional metallic wire.

Resumo Introdução O movimento ortodôntico bem sucedido está diretamente relacionado com a capacidade de os fios ortodônticos deslizarem sobre os bráquetes e tubos ortodônticos. Portanto, durante a movimentação ortodôntica a principal preocupação está diretamente ligada a fricção entre o suporte e o fio. Objetivo O objetivo deste estudo foi avaliar a influência de fios ortodônticos estéticos na resistência ao atrito. Material e método Foram utilizados 50 bráquetes-teste divididos em 5 grupos, de acordo com o fio retangular (n=10): G1 - grupo controle: fio metálico convencional (Morelli, Brasil) e fios estéticos (G2 - Ortho Organizer; G3 - Tecnident; G4 - Trianeiro; e, G5 - TP Orthodontics). Todos os fios apresentavam 0,019 x 0,025 polegadas e o bráquete era cerâmico, prescrição Edgewis e, torque e/ou angulação 0° e, canaleta 0,022 x 0,028 polegadas. O teste de resistência ao atrito sob força de tração foi realizado em uma máquina de ensaio universal Instron à velocidade de 1,0 mm/min e célula de carga de 500N. Os dados de resistência ao atrito foram submetidos à análise de variância (ANOVA) um fator e ao Teste de Tukey com nível de significância de 5%. Resultado O atrito (N) do fio metálico (8,07±0,43) foi significativamente maior que os fios ortodônticos estéticos: Ortho Organizer (4,01±0,25), Tecnident (3,871±0,31), Trident (4,47±0,26) e, TP (4,49±0,30) (p<0,05). Nenhuma diferença estatisticamente significativa foi observada entre os fios estéticos (p>0,05). Conclusão Conclui-se que os fios ortodônticos estéticos apresentam menor resistência ao atrito quando comparado ao fio metálico.

Evaluation of friction on self-ligating and conventional brackets associated with different types of archwires submitted to sliding mechanics

Aim: The aim of this study was to verify the frictional force during sliding mechanics in orthodontic tooth movement, using conventional metal brackets of the active and passive self-ligating types with stainless steel and copper nickel titanium archwires. Methods: This experimental in vitro study was conducted with conventional metal (Morelli, Sorocaba, SP, Brazil) brackets, active self-ligated (SLI Morelli, Sorocaba, SP, Brazil) and passive self-ligated (SLP Morelli, Sorocaba, SP, Brazil), with slot 0.022 x 0.028 inches and Roth prescription. The brackets were tested with rectangular section 0.019 x 0.025 inch copper nickel titanium and stainless steel archwires. For each type of bracket, 10 sets of plate/bracket/archwire segment (n=10) were fabricated. Non-parametric Kruskal Wallis and Dunn tests were used for comparison between types of brackets and Wilcoxon tests for comparison between types of archwires. Results: The results showed that the frictional force values were higher with copper nickel titanium than with stainless steel archwires (p<0.05). When copper nickel titanium archwires were used, the active self-ligating brackets showed higher frictional force values than the other types, followed by the conventional brackets. Lower frictional force values were observed with passive self-ligating brackets. For stainless steel archwires, no difference was observed between conventional and active self-ligating brackets, the passive self-ligating type presented lower frictional force values than the others. Conclusion: It was concluded that the higher frictional force was observed when active self-ligating brackets were associated with copper nickel titanium archwires. Lower frictional force was verified between passive self-ligating brackets combined with stainless steel archwires

Comorbidity of TMD and malocclusion: impacts on quality of life, masticatory capacity and emotional features

Aim: to evaluate the synergic impact of muscular TMD and malocclusion on quality of life, masticatory capacity and emotional features of young adults. Methods: this cross-sectional study comprised 4 groups (n= 15): G1, individuals without TMD or malocclusion; G2, with TMD and malocclusion; G3, with TMD and without malocclusion, and G4, without TMD and with malocclusion. Muscular TMD was diagnosed by RCD/TMD. Data included quality of life (OHIP-14), masticatory capacity test (X50), emotional stress (PSS-14), depression (MDI), pain intensity and salivary cortisol. Comparative statistical analysis included One-way ANOVA and Tukey post hoc test (X50, stress and cortisol) and GENMOD followed by Wald test (OHIP-14 and pain data). Fisher's and Pearson's association analysis were carried out. Results: Comorbidity of muscular TMD and malocclusion leads to significant lower masticatory capacity (p<0.05). TMD groups independently of the occlusal condition had considerably lower OHIP-14 scores and higher stress levels (self-perceived and hormonal) (p<0.05). There was no statistically significant difference of emotional depression among groups. A significant positive correlation was observed among quality of life, stress and pain perception. Conclusion: muscular TMD in the overlap of malocclusion potentializes their negative effect on masticatory capacity. In addition, the hindering effect of the comorbidity is variable, however, TMD has a greater negative impact on quality of life and stress, whilst malocclusion on mastication

Can the chlorhexidine gluconate solution potentiate the staining of polycrystalline ceramic brackets?

Aim: The present study aimed to assess, in vitro, the effect of chlorhexidine on the potentiation of polycrystalline ceramic bracket staining. Methods: Seventy-two polycrystalline ceramic brackets of upper right central incisors were divided into six groups (n=12) according to immersion solution. The groups were G1 - distilled water (control); G2 - chlorhexidine; G3 - coffee; G4 - red wine; G5 - chlorhexidine associated with coffee; and G6 - chlorhexidine associated with red wine. The samples were analyzed by means of a spectrophotometer according to the CIEL*a*b* system, and color change (ΔE*) was calculated. The readings were performed at the following times: T0 - After package removal and T1 - After staining. The data were analyzed by Kruskal Wallis and t tests (p<0.05) at 5% significance level. Results: The total color variation (ΔE*) was greater in the group that received chlorhexidine associated with red wine (p<0.05) and lower in the groups that received distilled water. All other groups showed greater value variations when compared to G1 and G2. Group G6 showed a greater color change due to the potentiation of chlorhexidine with the dye substance. Conclusion: It is concluded that chlorhexidine potentiates the staining caused by red wine in polycrystalline ceramic brackets

Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis / Efeitos dentoesqueléticos e tegumentares do aparelho de protração mandibular (APM) usando a análise cefalométrica de Ricketts

Objective: This study was designed to evaluate the skeletal, dental and soft tissue effects of mandibular deficiency treatment with the mandibular protraction appliance (MPA) using 12 factors of the Ricketts analysis. Material and method: This cross-sectional retrospective study sample consisted of a group (n = 27), with Class II malocclusion, convex facial profile, increased horizontal trespass and mandibular deficiency, with initial mean age of 12.27 and final of 15.18 years, treated with fixed appliance combined with the MPA, in an average time of 2.9 years. Initial and final radiographs were investigated using Ricketts analysis. The dependent t-test was used to compare the initial and final phases of the MPA group, with a significance level of 5%. Result: Statistically significant differences were observed for dental changes such as retrusion (p=0.000) and palatal inclination of the maxillary incisors (p=0.000); protrusion (p=0.000) and buccal inclination of the mandibular incisors (p=0.000); increased interincisal angle (p=0.002) and improved molar ratio (p=0.003). There was also a restriction of the anterior displacement of the maxilla (p=0.000) and a decrease in the mandibular plane angle (p=0.024). The variable inferior labial protrusion with significance (p=0.000), reiterated the improvement in the profile. Conclusion: The effects of MPA on correction of malocclusion Class II, verified by Ricketts analysis occurred predominantly by dentoalveolar changes, decrease in the Mandibular Plane Angle, and restriction of anterior displacement of the maxilla, which contributed to the improvement in the patient's profile.

Objetivo: Este estudo analisou as alterações dentárias, esqueléticas e tegumentares promovidas pelo Aparelho de Protração Mandibular (APM) por meio da análise de Ricketts. Material e método: A amostra contou com 27 pacientes (14 meninas e 13 meninos) com má oclusão de Classe II, perfil facial convexo, trespasse horizontal aumentado e deficiência mandibular, com idade média inicial de 12,27 e final de 15,18 anos, tratados com aparelho fixo combinado com o APM. A comparação das telerradiografias iniciais (T1) e finais (T2) foi realizada pelo teste t dependente, com nível de significância de 5%. Resultado: Observou-se diferença estatisticamente significante para a retrusão (p=0.000) e lingualização dos incisivos superiores (p=0.000), protrusão (p=0.000) e vestibularização dos incisivos inferiores (p=0.000), aumento do ângulo interincisivos (p=0.002), melhora da relação molar (p=0.003), restrição do deslocamento anterior da maxila (p=0.000), diminuição do ângulo do plano mandibular (p=0.024) e melhora do perfil facial (p=0.000). Conclusão: O APM promoveu alterações dentoalveolares, observadas principalmente pela diminuição do ângulo do plano mandibular e restrição do deslocamento para anterior da maxila que contribuíram para a melhora do perfil do paciente.

Evaluation of miniscrew angulation in the posterior maxilla using cone-beam computed tomographic image

ABSTRACT Objective: This study aimed at evaluating whether changes in the insertion angle is a determining factor in the positioning of the miniscrews body in a region with larger interradicular space in the posterior maxilla. Methods: Analysis of 60 posterior maxillary quadrants were made using images obtained by means of cone-beam computed tomographic image (CBCT), with 0.076-mm voxel, which presented a real miniscrew inserted in the mesial region of the maxillary first molars, serving as reference point for the placement of the virtual miniscrews. Measurements of the distances between roots were made in three points on the body of the virtual miniscrews (A, B and C), at four different angulations, 70o, 60o, 50o and 40o (T1 to T4), in relation to the long axis of the second premolar. This evaluation was made in four groups, selected in accordance with the disposition of the roots of the second premolars and first molars: Group 1 (all types of roots), Group 2 (convergent roots), Group 3 (divergent roots) and Group 4 (parallel roots). Results: There were no statistically significant differences in the measurements of points A, B and C, at the different angles (70o, 60o, 50o and 40o) and in the different groups (p > 0.05). Conclusions: Changes in the insertion angle is not a determinant factor in the positioning of miniscrews body in regions with larger interradicular space in posterior maxilla.

RESUMO Objetivo: o presente estudo objetivou avaliar se alterações no ângulo de inserção do miniparafuso são um fator decisivo para a adaptação do corpo do parafuso em áreas com espaço inter-radicular aumentado, na região posterior da maxila. Métodos: foram realizadas análises em 60 quadrantes maxilares posteriores, a partir de imagens obtidas por tomografia computadorizada de feixe cônico (TCFC), com voxel de 0,076 mm, as quais apresentavam um miniparafuso real inserido na região mesial dos primeiros molares superiores, utilizado como ponto de referência para a inserção de miniparafusos virtuais. As distâncias inter-radiculares foram mensuradas utilizando-se três pontos marcados no corpo dos miniparafusos virtuais (A, B e C), inseridos com quatro angulações diferentes (70°, 60°, 50° e 40°) (T1 a T4) em relação ao longo eixo do segundo pré-molar. A avaliação foi realizada em quatro grupos, selecionados de acordo com a disposição das raízes dos segundos pré-molares e primeiros molares: Grupo 1 - contendo todos os tipos de raízes; Grupo 2 - raízes convergentes; Grupo 3 - raízes divergentes; e Grupo 4 - raízes paralelas. Resultados: não houve diferença estatisticamente significativa entre as medidas dos pontos A, B e C nas diferentes angulações (70°, 60°, 50° e 40°) ou entre os grupos (p > 0,05). Conclusões: alterações no ângulo de inserção dos miniparafusos não são um fator decisivo para a adaptação do corpo do parafuso, em áreas com espaço inter-radicular aumentado entre primeiro molar e segundo pré-molar superiores.

Evaluation of different types of self-ligating brackets guided by electromagnetic field simulator on rotational control

Aim: The objective of this study was to measure and compare the in vitro performance of active and passive self-ligating brackets in orthodontic rotation by means of an electromagneticfield simulation. Methods: The study sample consisted of 32 mandibular right central incisor brackets (n=8), slot 0.022", that were divided into the following groups: 1) BioQuick® (Forestadent, Pforzheim, Germany) active brackets; 2) In- Ovation®R (Dentsply-GAC, Central Islip, New York, USA) active brackets; 3) Damon-Q® (Ormco, Orange, California, USA) passive brackets, and 4) Smartclip® (3M, Monrovia, California, USA) passive brackets. The orthodontic wire used was CuNiTi round section 0.016", thermoactivated at 35o C (ORMCO- Orthodontics Glendora, California, USA). The experiment wasperformed in a simulator machine, composed of two fixedlateral axes and a movable central axis, which simulated the dental rotation. Qualitative analysis (n = 4) was performed using SEM. After the descriptive and exploratory analysis, the yield and grade data were submitted to one-way analysis of variance (ANOVA) followed by the Tukey test, considering the level ofsignificance of 5%. Results: In-Ovation®R brackets showedsignificantly higher yield than BioQuick® and Damon-Q®. Damon-Q® brackets presented a significantly lower mean valuethan In-Ovation R and Smartclip®. BioQuick® did not differsignificantly from Damon-Q® and Smartclip®. In-Ovation®R did not differ significantly from Smartclip®. Conclusion: In the present study, it was observed that there is a difference in rotational control in the different self-ligating brackets tested being the best rotational control was the In-Ovation R® group (active), followed in descending order by the groups Smartclip® (passive), Bioquick® (active) and Damon Q® (passive)

Root morphology can be a risk factor for periodontal damage and root resorption in orthodontic movement

Aim: The study evaluated, using histomorphometry, the percentage of hyaline area in periodontal ligament (PDL) and root resorption in orthodontic tooth movement (OTM). Methods: Ten rats were divided into two groups. G3 Group (n=5), with 3 days of OTM and G7 Group (n=5), with 7 days of OTM. A Control Group (n=5) consisted of contralateral teeth of each animal, which were not moved. Maxillary left first molar was moved, using stainless steel spring connected to the incisors with 40g force. Microscopic analysis was done in transversal sections of the mesiovestibular (MV) and distovestibular (DV) roots in the cervical level. Results: There was a PDL hyaline area in the DV root of 6.2% in G3 and 1.8% in G7. The root resorption area in G7 was 0.9%. On MV root and Control Group were not found occurrences of hyaline areas in PDL and no root resorption. Conclusions: Based on the results obtained, it might be concluded that smaller roots showed higher frequency of hyaline areas and root resorption (AU)

Debonding forces of different pads in a lingual bracket system

ABSTRACT Objective: To evaluate the shear bond strength of lingual orthodontic brackets with resin or metal pads, the location of bond failure and the adhesive remnant index (ARI). Methods: A total of 40 extracted upper premolars were randomly divided into two groups of 20 each: bonding with brackets having (1) pads with extended resin directly on the lingual surface of teeth, and (2) pads with metal custom base on the lingual surface of teeth. The debonding force was measured with an Instron universal testing machine. A Student's t-test was used to assess the difference between groups (α = 0.05). Results: The results showed a significant difference between the groups (p < 0.001). The shear bond strength of metal pads was significantly higher than resin pads. Conclusions: Within the limitations of this in vitro study, it was concluded that the bond strength of lingual brackets with metal pads was higher than that of brackets with composite resin pads, due to the metal part being a single unit and welded. The failure location in the region between the bracket and the resin pad affected a higher percentage of the resin pads than the metal pads.

RESUMO Objetivo: avaliar a resistência de união ao cisalhamento de braquetes ortodônticos linguais com pads em resina e metálicos, assim como os locais de ocorrência das falhas, além do Índice de Adesivo Remanescente (ARI). Métodos: 40 pré-molares superiores extraídos foram aleatoriamente divididos em dois grupos de 20 espécimes cada, para a colagem de braquetes com: 1) pads em resina, estendida diretamente na face lingual dos dentes; e 2) pads com base metálica customizada, na face lingual dos dentes. A força de descolagem dos braquetes foi mensurada por meio de uma máquina de ensaio universal (Instron). O teste t de Student foi utilizado para avaliar diferenças intergrupos (α = 0,05). Resultados: os resultados demonstram haver diferença significativa intergrupos (p < 0,001). A resistência de união ao cisalhamento dos pads metálicos foi significativamente maior em comparação aos pads em resina. Conclusões: dentro das limitações desse estudo in vitro, foi possível concluir que a resistência de união de braquetes linguais com pads metálicos foi superior à resistência de braquetes com pads em resina composta, uma vez que os pads metálicos customizados e os braquetes são fundidos, formando uma única unidade. A porcentagem de falhas de colagem na região entre o braquete e o pad foi maior para os pads em resina, em comparação aos pads metálicos.

Influence of Thermal Cycles Number on Bond Strength of Metallic Brackets to Ceramic

Abstract The aim of this study was to evaluate the effect of different number of thermal cycles on the shear bond strength (SBS) of metallic orthodontic brackets bonded to feldspathic ceramic by a composite resin. Twenty-five ceramic cylinders were etched with 10% hydrofluoric acid for 60 s and received two layers of silane. Brackets were bonded to the cylinders using Transbond XT and assigned to 5 groups (n=5): Group 1 - Control group (without thermal cycling); Group 2 - 500 thermal cycles; Group 3 - 5,000 thermal cycles; Group 4 - 7,000 thermal cycles and Group 5 - 10,000 thermal cycles. Light-activation was carried out by Radii Plus LED. SBS testing was carried out after 24 h of storage in deionized water and thermal cycling (5/55 oC and 30 s dwell time). Five brackets were bonded to each cylinder, totalizing 25 brackets for each group. Data were submitted to one-way ANOVA and Tukey’s test (α=0.05). The Adhesive Remnant Index (ARI) was evaluated at 8× magnification. The SBS (MPa) of control group (9.3±0.8), 500 (9.0±0.7) and 5,000 (8.4±0.9) thermal cycles were significantly higher than those after 7,000 (6.8±0.6) and 10,000 (4.9±1.0) thermal cycles (p<0.05). The ARI showed a predominance of Scores 0 (adhesive failure) prevailed in all groups, as shown by the ARI, with increased scores 1 and 2 (mixed failures) for control group and 500 thermal cycles. In conclusion, thermal fatigue may compromise the bonding integration between metallic brackets and ceramic restorations. For in vitro testing, use of at least 7,000 cycles is advised to result in significant fatigue on the bonding interface.

Resumo O objetivo neste estudo foi avaliar o efeito de diferentes números de ciclos térmicos na resistência da união de braquetes metálicos à cerâmica feldspática usando resina composta. Vinte e cinco cilindros de cerâmica foram condicionados com ácido fluorídrico a 10% por 60 s e duas camadas de silano. Braquetes foram fixados nos cilindros usando Transbond XT e depois separados em 5 grupos (n=5): Grupo 1 - Grupo Controle (sem ciclagem térmica); Grupo 2 - 500 ciclos térmicos; Grupo 3 - 5.000 ciclos térmicos; Grupo 4 - 7.000 ciclos térmicos e Grupo 5 - 10.000 ciclos térmicos. A fotoativação foi realizada com aparelho LED Radii Plus. O ensaio de resistência de união ao cisalhamento foi realizado após armazenagem por 24 h em água deionizada ou após a ciclagem térmica (5º/55 ºC, com banhos de 30 s cada). Cinco braquetes foram fixados em cada cilindro, totalizando 25 bráquetes por grupo. Os dados foram submetidos à análise de variância de um fator e ao teste de Tukey (α=0,05). O Índice de Remanescente Adesivo (IRA) foi avaliado com aumento de 8x. Os valores de resistência (MPa) dos grupos controle (9,3±0,8), 500 (9,0±0,7) e 5.000 (8,4±0,9) ciclos térmicos foram significantemente maiores do que os grupos submetidos à 7.000 (6,8±0,6) e 10.000 (4,9±1,0) ciclos térmicos (p<0,05). O IRA mostrou predominância do escore 0 para todos os grupos, com aumento de escores 1 e 2 para os grupos controle e submetidos a 500 ciclos térmicos. Em conclusão, a fadiga térmica pode comprometer a união entre os braquetes metálicos e as restaurações cerâmicas. Para testes in vitro, o uso de pelo menos 7.000 ciclos é recomendado para determinar fadiga significante na interface de união.

Signs and symptoms of temporomandibular disorder and patients' satisfaction before and after orthognathic surgery

Aim: To evaluate signs and symptoms of temporomandibular joint disorder and satisfaction in patients before and after orthognathic surgery. Methods: The sample consisted of 15 patients aged between 19 and 47 years old, indicated for orthodontic-surgical treatment. All patients answered na anamnesis questionnaire based on Helkimo Anamnestic Index to evaluate subjective symptoms and underwent a clinical evaluation based on Helkimo Disfunction Index, applied at three time points: before (T0), three (T1) and six months (T2) after surgery. Statistical models used were χ2 test (Chi-square), Tukey test, confidence interval and analysis of variance (ANOVA). Results: Statistical analysis revealed no significant difference in the incidence of joint sounds, maximum mouth opening, deviation of mouth opening and pain in the TMJ region (p>0.05). No patient presented worsening of the symptomatology. As regards muscular pain, there was a statistically significant improvement with time (p<0.05) and 86.7% of patients reported that they were satisfied with the obtained results. Conclusions: Improvement of TMD after orthognathic surgery may not be the result of correcting malocclusion and satisfaction with the results can be a factor of TMD improvement (Au)

Influence of adhesive and thermal cycling on the bond strength of ceramic brackets to dental ceramic

Aim: This in vitro study investigated the effect of the application of an adhesive, silane and thermal cycling (TC) on the shear bond strength (SBS) of ceramic brackets to feldspathic ceramic. Methods: 16 cylinders of feldspathic ceramic were etched with hydrofluoric acid and divided into four groups (n=4): G1 - silane, without TC; G2 ­ silane, with TC; G3 - adhesive, without TC; G4 - adhesive, with TC. One layer of silane was applied on the surface of cylinders in G1 and G2 e one layer of photo-activated adhesive Single Bond Universal was used in G3 and G4. Ceramic brackets were bonded using Transbond XT. The SBS data were subjected to two-way ANOVA and Tukey's post hoc test (α=0.05). The Adhesive Remnant Index (ARI) was evaluated at 40× magnification. Results: Silane was more effective than adhesive on the SBS of the brackets to ceramic (p<0.05). TC decreased significantly the SBS values compared with the groups without TC (p<0.05). The ARI results showed predominance of score 0. Conclusions: Groups with silane showed higher SBS than groups with adhesive. TC influence significantly on the bond strength. Regarding ARI, score 0 predominated in all groups (Au)

Controle por meio de tomografia computadorizada para tracionamento de caninos superiores permanentes não irrompidos – relato de caso / Using CT scan as control for the traction of unerupted permanent maxillary canines – case report

O objetivo deste relato de caso foi mostrar o tracionamento de caninos impactados em posições desfavoráveis numa paciente de 13 anos e 3 meses. Foram realizadas uma tomografia computadorizada e radiografia panorâmica inicial para averiguação da posição e angulação dos caninos. A tomografia mostrou o canino superior direito em posição horizontal em relação aos dentes adjacentes e localizado apicalmente, e o canino superior esquerdo, em uma angulação favorável para o tracionamento. A paciente foi encaminhada para extração dos caninos decíduos superiores direito e esquerdo. Em seguida, realizou-se a colagem do aparelho fixo superior com molas de secção aberta de aço inoxidável para obtenção do espaço suficiente para os caninos e, após, iniciou-se o tracionamento. Durante o tratamento ortodôntico, controles foram obtidos com tomografias após 11 meses de tratamento e dois anos pós-tratamento. Assim que ocorreu a irrupção parcial da coroa do canino superior direito na cavidade bucal, colou-se um botão, e com arcos de níquel titânio superelásticos, o dente foi tracionado lentamente (para não sofrer alterações de tecido mole) em direção ao arco dentário. Na finalização, a paciente utilizou elásticos intermaxilares para auxiliar o posicionamento correto no arco dentário. Os resultados obtidos foram muito satisfatórios considerando a angulação horizontal do canino superior direito na tomografia inicial, e obteve-se o correto encaixe dos dentes em Classe l de caninos com grande harmonia e estética.

The aim of this case report was to present the case of a 13.3 year old patient submitted to traction of impacted canine in a very unfavorable position. CT scan and initial panoramic radiograph were performed to determine the position and angulation of the canines. The CT scan showed tooth 13 in an apical position horizontally to the adjacent teeth. On the other hand, the tooth 23 was at a favorable angle for traction. The patient was referred for extraction of deciduous teeth 53 and 63. Then a fixed appliance with stainless steel open coil springs was installed to open space for the canines. After obtaining enough space in the arch, one closed coil spring was installed in the regions of canines to maintain the space and then start the traction. During orthodontic treatment CT scans performed at 11 months and again 2 years after treatment. As a part of the 13 crown erupted in the oral cavity, a button was installed and superelastic NiTi wire was used to slowly traction the tooth (not to suffer soft tissue changes) toward the arch. Following treatment, the patient wore intermaxillary elastics to aid in its final positioning. The obtained results were very satisfactory where in the initial CT scan tooth 13 was in an almost impossible angle for the traction to be performed. Proper occlusion of teeth in Class l canine relationship was achieved with great harmony and aesthetics.